Increased risk of blood transfusion in patients with diabetes mellitus sustaining non-major burn injury.

Dr Linda Mai1, A/Prof Katrina Spilsbury2,5, A/Prof Dale Edgar1,2,3,4, Mr.  Aaron Berghuber3, Prof Fiona Wood1,2,3,4

1Fiona Stanley Hospital, Murdoch, Australia, 2Institute for Health Research, Fremantle, Australia, 3Fiona Wood Foundation, Murdoch, Australia, 4State Adult Burns Unit, Murdoch, Australia, 5University of Notre Dame, Fremantle, Australia


Background: Due to increased mortality and morbidity associated with blood transfusions, identifying modifiable predictors of transfusion are vital to prevent or minimise blood use. We hypothesised that burn patients with diabetes mellitus were more likely to be prescribed a transfusion. These patients tend to have increased age, number of comorbidities, infection risk and need for surgery which are all factors associated with blood use.

Objective: To determine whether patients with diabetes mellitus who have sustained a burn ≤20% total body surface area (TBSA) are at higher risk of receiving packed red blood cell (PRBC) transfusion compared to those without diabetes mellitus.

Method: This was a retrospective cohort study including patients admitted to the major Burns Unit in Western Australia for management of a burn injury. Only the first hospital admission between May 2008 to February 2017 were included.

Results: Among 2,101 patients with burn injuries ≤20% TBSA, 48 (2.3%) received PRBC and 169 (8.0%) had diabetes. There were 13 (7.7%) diabetic patients that were transfused versus 35 (1.8%) non-diabetic patients. Patients with diabetes were 5.2 (p=0.034) times more likely to receive PRBC after adjusting for percentage TBSA, haemoglobin at admission or prior to transfusion, number of surgeries, total comorbid burden and incidence of infection. As percentage TBSA increases, the probability of PRBC increases at a higher rate in diabetic patients.

Conclusions: Diabetic patients with burn injuries ≤20% TBSA have a higher probability of receiving PRBC compared to patients without diabetes. This effect was compounded in burns with higher percentage TBSA.


Linda graduated from the University of Western Australia in 2018 and is working as a Resident Medical Officer at the South Metropolitan Health Service. Since her first year of medical school in 2015, Linda has been proactive in research focusing on optimising perioperative management of Burns patients. As Linda becomes more experienced as a medical practitioner, she looks forward to deepening her commitment to Burns research and further contributing to the advances in Burns care, especially during these everchanging times.

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